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2Learning Outcomes List the main classes of antidepressant drugDescribe the effects of antidepressant drugs on synaptic monoamine levelsDescribe the principal adverse effects of each drug classDefine the term “mood stabiliser” and give examples

21Selective NA reuptake inhibitors?Atomoxetine inhibits NET and also DATReboxetine selective inhibitor of NET which was approved for major depression in 1997Systematic review and meta-analysis (BMJ 341: c4737–c4737. doi: /bmj.c4737) has now determinedno overall significant difference compared to controlinferior response compared to SSRIsgreater harm than placebo or SSRIs for adverse events

24Efficacy of current antidepressantsMost classes of drug have a similar clinical efficacy (40-70%)Side effect profiles differMost have delayed onset of action (several weeks)How do they actually work?Long-term adaptation in receptor density/function?Alterations in corticosteroid receptors/HPA function?